In this time of global uncertainty, many people are experiencing increased levels of stress and anxiety. This is especially true for adults and young people with pre-existing mental health issues, including eating disorders. In view of the escalating situation with Covid-19, people with an eating disorder may be particularly vulnerable, since food is often used as a response to difficult feelings and/or to regain a sense of control over life. Decreased access to food, support, usual activities and friends will all add to the risk of deterioration in eating disorder symptoms Many people with an eating disorder may already be critically unwell, or at increased risk of becoming medically compromised. With many people not being able to visit their GP or health practitioner in person for medical monitoring, there is an increased risk of deterioration not being picked up and responded to as quickly. Life as we know it is no longer life as we knew it.
In view of the above, it is paramount that we each do what we can to look after ourselves, mentally and physically. Below are some tips which we hope may be of help to our existing clients, and to anyone who is currently managing an eating disorder.
- Structure and routine is known to be incredibly helpful in recovery from an eating disorder. Even though your usual routine may be disrupted, it is still crucial to try to keep as much of a daily routine as possible. Maintaining structured meal and snack times will be especially important, so make sure you keep to your usual eating structure if you can.
- Keep a focus on self-care activities within your daily routine (what would feel soothing/relaxing/ enjoyable). And as much as possible try to keep your old routine going via other means – talk to friends electronically as much if not more than you would usually do; if you used to do an art, yoga or music class once a week, look to do this on line. Structure is crucial and the importance of keeping as familiar a routine as possible should not be underestimated.
- Decreased access to food is a huge concern for people with eating disorders and those that support them. There is little we can do about this, however, guidance would always be to try to obtain your safe foods if possible. Ask friends or family who are able to make it to the supermarket to help you, and try to buy food before you run out to increase the chances of keeping familiar foods in stock. Where it isnt possible to obtain your safe foods, make a list of possible alternatives. Try to stay as close to your safe foods as possible, e.g. buying a different brand or variety of food. Food planning will be helpful, so you know what you are able to have when. Remember that safe foods may not always have been safe foods, they became safe by overcoming the anxiety of trying something new, and new foods can become safe in exactly the same way. If there are foods you know you used to eat that felt safe, start with these, and build them into your plan. It is vital not to cut out foods, but to try to find alternatives wherever possible.
- Try to stay connected with friends and family online. Remember that everyone is in the same boat, and talking about what you are experiencing will be just as important as it always was. Bottling up negative feelings will only serve to strengthen your eating disorder. Ask friends or family to check in with you and let them know you are finding things hard. There are also a number of online ED support groups – take a look at the national ED charity Beat’s website (www.b-eat.co.uk), or your local charity (e.g www.SWEDAuk.org) to see what support they may be offering. And of course keep attending your therapy sessions and medical appointments, either in person or (more likely) via phone or Skype. Recovery does not stop because of Covid-19 and you will need support to stay as well as possible.
- Keep attending your therapy sessions and medical appointments, via remote means. We have no evidence to suggest that therapy delivered electronically, especially once a therapeutic relationship has already been established, is less effective than face to face working. Recovery does not stop because of Covid-19 and you will need support to stay on track. For those not in therapy, see what is on offer and trial online therapy, even if it wouldn’t be your preferential way of working.
- Think about what has helped you cope with difficult times in the past, and try to implement as many of these coping strategies as you can. You may be surprised how many coping strategies are still possible even during anational emergency such as COVID-19.
- Remember the importance of self-compassion. Be kind to yourself, not critical of yourself. Normalise many of the difficult emotions you are experiencing – these are incredibly difficult times and we are all coping with this situation the best that we can.
Blog by Dr Hollie Shannon, photo by Shane on Unsplash